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Application of ureterorenoscope and flexible ureterorenoscope lithotripsy in removing calculus from extracorporeal living donor renal graft: a single-center experience

机译:输尿管镜和柔性输尿管镜碎石术在去除体外活体供体肾移植物中的结石中的应用:单中心经验

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Abstract Here, we reported our clinical application of ureterorenoscope (URS) and flexible URS lithotripsy in stone removal on 10 cases of excised living donor kidney graft. After the extraction of donor kidney by retroperitoneal laparoscopy, the donor graft was perfused with 4?°C HCA solution. Calculus between 2–4?mm were removed intact with lithotomy forceps under direct vision of URS. Larger calculi of >4?mm were fractured with flexible URS combining holmium laser lithotripsy. Fragments of the calculus were extracted with basket extractor and lithotomy forceps. All operations were successful. The operation time was 14–31?min (average 21.2?±?6.3?min). The kidneys were then transplanted to the recipients using routine procedure. The transplanted kidneys functioned well after transplantation. Gross hematuria resolved 1–4 d after operation (average 2.6?±?0.9 d). The transplanted kidneys functioned well without early complications such as functional recovery delay and acute graft rejection. The donors and recipients were followed for 12 months. The size of the transplanted kidneys was normal and new stones or urinary obstruction was not seen upon urinary color Doppler ultrasound examination. In conclusion, we believe it is feasible, safe and effective to use URS or flexible URS combining holmium laser lithotripsy on extracorporeal living donor kidney.
机译:摘要在这里,我们报道了输尿管镜(URS)和柔性URS碎石术在切除活体供体肾脏移植物10例中的结石清除的临床应用。通过腹膜后腹腔镜抽出供体肾脏后,用4℃C HCA溶液灌注供体移植物。在URS的直视下,用截石钳完整切除2-4毫米之间的牙结石。结合U激光碎石术的柔性URS将大于4?mm的较大结石骨折。用篮式提取器和截石钳提取牙结石的碎片。所有操作均成功。手术时间为14-31?min(平均21.2?±?6.3?min)。然后使用常规程序将肾脏移植到受体。移植后的肾脏功能良好。大血尿在手术后1-4 d消退(平均2.6±±0.9 d)。移植的肾功能良好,没有早期并发症,如功能恢复延迟和急性移植排斥反应。追踪捐赠者和接受者12个月。移植的肾脏大小正常,在尿彩色多普勒超声检查中未发现新的结石或尿路阻塞。总之,我们认为在体外活体供体肾脏上使用URS或柔性URS结合激光碎石术是可行,安全和有效的。

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